August 15, 2012

Risk of Self-Injury and Suicide Attempts for Girls with ADHD

A new study from the University of California, Berkeley (UC Berkeley) discovered that girls with Attention Deficit Hyperactivity Disorder (ADHD) are more likely to attempt self-injury and suicide as they become older.

To begin, families and girls with ADHD hope that symptoms like disruptive behavior and fidgety actions will decrease as they mature. However, the study from UC Berkeley showed that these girls tend to internalize their feelings of inadequacy and their struggles with the disorder. As a result, they are two times more likely to harm themselves and three times more likely to commit suicide than their peers.

The study spanned a 10-year period and consisted of the largest-ever sample of girls who were diagnosed with ADHD during childhood.

"Our findings of extremely high rates of cutting and other forms of self-injury, along with suicide attempts, show us that the long-term consequences of ADHD females are profound," continued Hinshaw in the statement.

The results of the project, published in a recent edition of the journal of Consulting and Clinical Psychology, are consistent with earlier findings made by the UC Berkley team. The study highlighted how, even though the girls with ADHD will have fewer visible symptoms of the disorder, they will continue to suffer internally. The researchers believe that the findings challenge the view that girls can “outgrow” ADHD.

"ADHD can signal future psychological problems for girls as they are entering adulthood," remarked Hinshaw in the statement. "Our findings reinforce the idea that ADHD in girls is particularly severe and can have serious public health implications."

The first study first began in 1997, when the team tracked a diverse group of girls, whose ages ranged from 6 to 12, from adolescence to adulthood. They were from different racial and socio-economic backgrounds, mostly in the San Francisco Bay area. The new UC Berkley study examined 140 of the girls 10 years after the first study, many of who were between the ages of 17 and 24. The investigators compared the girls´ academic, emotional, and behavioral development with 88 other girls who did not have the disorder. They also looked at particular subgroups of ADHD; one group had poor attention, another group had poor intention plus hyperactivity and impulsivity. Furthermore, they completed follow up visits five years after and ten years after the initial visit.

Through the first project, the researchers saw that girls who had ADHD had more difficulty to achieve academically and suffered rejection from their peer group. They also dealt with a learning gap, when compared to their peers, and encountered eating disorders and substance abuse.

In the second study, the scientists discovered that the group that had inattention, impulsivity, and hyperactivity had the highest likelihood of attempting self-injury and suicide during early adulthood. Through intensive interviews with families, researchers pooled personal reports on drug abuse, driving behavior, eating habits, as well as self-harm and suicide attempts. They also determined key cognitive function like planning skills, goal setting, and task completion despite distractions.

"ADHD in girls and women carries a particularly high risk of internalizing, even self-harmful behavior patterns," commented Hinshaw in the statement. "We know that girls with ADHD-combined are more likely to be impulsive and have less control over their actions, which could help explain these distressing findings."

Overall, the team concluded that monitoring and treatment are necessary for girls with ADHD.

"A key question is why, by young adulthood, young women with ADHD would show a markedly high risk for self-harm “¦ Impulse control problems appear to be a central factor," remarked authors in the article.

The investigators believe that the study is particularly important as ADHD can affect over 5 million children between the ages of 3 and 17, which amounts to around one in 11 who show symptoms of the disorder. Those who have ADHD tend to be hyperactive, have poor concentration, and are impulsive. Treatments of the disorder include stimulate medications and different types of behavior therapy.

"The overarching conclusion is that ADHD in girls portends continuing problems, through early adulthood," concluded the authors in the study. "Our findings argue for the clinical impact of ADHD in female samples, the public health importance of this condition on girls and women, and the need for ongoing examination of underlying mechanisms, especially regarding the high risk of self-harm in young adulthood."